Miriam's Lessons for Modern Doctors

In Numbers 12:1-15, G-d punishes Miriam for speaking against Moses by giving her leprosy and banishing her from the camp for 7 days. Appalled, Moses cries out, “G-d, heal her.” From this incident, Jewish scholars developed the concept of “lashon hara” (evil tongue, bad words), and have interpreted lashon hara as a misdeed worse than idolatry, adultery, or even murder, as its damage can reach far beyond the specific action or intent. “The Sages compared lashon ha-ra to an arrow: once shot, it cannot be taken back, and indicated that the evil tongue can be more deadly than the sword because it can ‘speak in Rome and kill in Syria, speak in Syria and kill in Rome’” (J PE’AH 1:1)1While stories of bad words today may not have such dramatic outcomes, there are yet many lessons that modern doctors can learn from studying this Biblical incident. By considering the speech we use in speaking with our patients and colleagues, as well as the words we choose in our writing and in our own private thoughts, we can take concrete positive steps to ensure the well being of our patients and of ourselves.

My goals for this presentation are to illustrate how the words we use influence patient care, patient satisfaction and even patient outcomes. For example, Lown writes about a patient who mistook the initials “TS” uttered hurriedly on rounds to mean “terminal situation” rather than “tricuspid stenosis,” a term the patient might not have known or imagined. The immediate impact of those words was so great that Dr. Lown could not dissuade the patient from her original interpretation, and she died shortly thereafter.2 In another example, a patient who suffers from severe nausea with some narcotics but not others is routinely labeled as “drug seeking” and then undermedicated after volunteering this important information, even for ailments like kidney stones. ​Words can tear us apart. Words can also heal us, just as Moses’s simple prayer moved G-d to heal Miriam. The literature cites many examples where the stress response from hearing or being the object of bad gossip and/or bullying results in PTSD or even suicide. In this paper I will reflect on the impact of a doctor’s own remarks after a patient has already sought out care, amplifying both how words can harm and how words can heal, so as to inspire others to consider their power.